Occupational exposure and liver cancer in women: results of the Multicentre International Liver Tumour Study (MILTS).

The association of occupational variables and hepatocellular cancer (HCC) is discussed with particular reference to women, as little research has been undertaken on their behalf. This paper reports the results of an international case-control study concerning women and involves 317 cases of HCC and 1789 controls. Working in the chemical industry was shown to have only a marginally significant risk associated with HCC: adjusted odds ratio (OR) and 95% confidence interval 2.37 (1.04-5.41). Other non-significantly elevated ORs were observed in the pharmaceutical, plastics, PVC-producing, farming and butchery industries. Little consistency was found among the risk estimates for HCC, based on three different analytical approaches. None of the analyses showed a linear trend of risk with increasing duration of exposure. However, the numbers of exposed cases and controls were small for many of the occupations and therefore the study power and precision were low. We failed to find important and consistent evidence for a relationship between HCC in women and occupational variables. However, even weak evidence of occupational risk warrants careful consideration in future studies.

Diesel exhaust and lung cancer mortality in potash mining.

BACKGROUND: Findings from experimental studies on rodents and from epidemiological studies suggest that diesel exhaust may cause lung cancer. There is evidence that in several occupations, e.g., truck drivers and railway workers, the risk of lung cancer increases with duration of employment, and exposure to diesel exhaust provides the most likely explanation for these elevations of risk. METHODS: We investigated the association between lung cancer mortality and exposure to diesel exhaust in a cohort study. The cohort comprised 5, 536 male potash miners who were followed from 1970 to 1994. Exposure was assessed from concentration measurements of the total carbon (i. e., elemental and organic carbon in total) in personal dust samples. The concentration values were multiplied by years of exposure to give a quantitative exposure measure. The concentration levels ranged from 0.12 to 0.39 mg/m(3) total carbon in fine dust. Work histories and smoking habit data were obtained from medical company records. Causes of death were ascertained from death certificates. RESULTS: During the follow-up period, 424 deaths were recorded, including 133 of cancer, 38 of lung cancer. The relative risk of lung cancer between two groups with high and low exposure was 2.2 (95% confidence interval 0.8-6.0). With Cox regression, we found a lung cancer relative risk 1.7 (0.5-5.8) after twenty years of exposure. Extensive scrutiny proved smoking not to be a confounder in this study. CONCLUSIONS: The principal finding of the study is a doubling of relative lung cancer risk after twenty years of exposure in the workplaces with highest exposure. However, the observed elevation is nonsignificant even at a 90% level. Further follow-up is intended to enhance the study power.

New high resolution typing strategy for HLA-A locus alleles based on dye terminator sequencing of haplotypic group-specific PCR-amplicons of exon 2 and exon 3.

In this study, a new sequencing-based typing strategy for the HLA-A locus is presented which involves group-specific separate amplification of exon 2 and 3 of HLA-A alleles in a first step. Conserved HLA-A locus-specific primers of intron 1 or 3 were combined in 10 primer-mixes with group-specific primers hybridizing to the 5'- or 3'-end of exon 3 or 2 for pre-typing of the HLA-A alleles in 14 allelic groups. Maximally four overlapping short amplicons are produced under identical polymerase chain reaction (PCR) conditions with individual separate amplification of exon 2 and exon 3 of the haplotypic alleles in most heterozygous combinations. Time- and money-saving one-directional Big Dye Terminator cycle sequencing is shown to provide reliable high resolution typing of the HLA-A alleles, even in a few cases of two amplicons in one primer reaction mixture. In comparison, to other sequencing-based typing (SBT) techniques the applied typing strategy minimizes the risk of unequal amplification or of drop-outs of one of the haplotypic alleles and allows unequivocal definition of the cis/ trans linkage of polymorphic positions of the complete exon 2 and exon 3 in most heterozygous cells. This also includes detection of new alleles differing in the polymorphic template generating primer annealing sites as well as in unusual combinations of known exon 2 and 3 sequences. With 10 primer sets working under identical conditions for pre-grouping and separate amplification of the haplotypic alleles our SBT procedure also could be implemented in clinical settings of large-scale stem cell donor histocompatibility testing for fast molecular HLA-A matching.

[Epidemiology of stress fractures from an occupational health viewpoint]. / Zur Epidemiologie von Ermüdungsbrüchen aus arbeitsmedizinischer Sicht.

Stress fractures may occur after extremely high exercises in sports, military training, and occupational activities. The pathogenetic mechanisms include processes of material fatigue as well as repair capacities of the bone. By means of szintigraphic technique a sensitive tool for diagnostics of stress fractures is available. Recently, stress fractures of the vertebral processes only are acknowledged as a professional disease in Germany. As a rule, in orthopaedic and surgical practice fatigue fractures of other bones are considered as cases of accidental injuries.

[The search for interventional priorities for the prevention of chronic diseases in females employed in the health service]. / Fahndung nach Interventionsschwerpunkten zur Prävention chronischer Krankheiten bei im Gesundheitsdienst beschäftigten Frauen.

With a view of clearing up certain influence of the working and living conditions on health, some results of control examinations in occupational medicine from the years 1985 to 1988 of women employed in the health service (n = 86,769) were analyzed and compared with those of the investigations carried out on all women in the GDR (n = 662,578). The tracking down of significant deviations in the age-standardized prevalence rates for chronic health disturbances was performed by means of a specialized computer programme for the health of women and for 7 occupations. Among other things, it was possible to prove permanently increased prevalence rates for chronic diseases of the kidneys/urinary passages in the overall population and in the personnel for laboratory diagnostics, as well as an increased prevalence of hypertension in day nursery educators. The elaborated strategy for tracking down work-related diseases and chronic diseases proved effective and can also be used for issues in other economic sectors.

[Occupational medicine aspects of the health needs of elderly workers]. / Arbeitsmedizinische Aspekte des Betreuungsbedarfs älterer Werktätiger.

The industrial-medical dispensatory care as an important field of the prophylactic health protection of the population of the GDR ensures the total covering of the working people in youth and in pre-pension age. Between these periods of life there is a special dispensatory care for those workers for whom defined exposures, strains and standards exist at their workplaces. Results of about 500,000 industrial-medical check-ups of the year 1985, occupational diseases, their incidence rates and conclusions for the demand for care are reported under special consideration of the working people from the 45th year of life, differentiated between by their sex. The high rates of findings and the considerable percentage of fitness restrictions in working people from the 45th year of life prevailingly caused by chronic diseases of the locomotor system, cardiovascular diseases, defective vision, defective hearing and by chronic bronchitis necessitate a further improvement of the quality and efficiency of medical care, which is desired by the revised edition of the Methodology of Industrial-Medical Fitness Examinations and Check-Ups from 1987. Possibilities and objectives of the consolidation of the medical check-up conceptions for working people beyond 1990 are referred too.